Individual
NICOLE CORREA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
425 W SURF ST APT 315, CHICAGO, IL 60657-6127
(440) 552-8640
Mailing address
425 W SURF ST APT 315, CHICAGO, IL 60657-6127
(440) 552-8640
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
01/12/2021
Last updated
01/12/2021
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